Academic literature on the topic 'Qualitative research; systematic review; evidence-based practice'
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Journal articles on the topic "Qualitative research; systematic review; evidence-based practice"
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Bahtsevani, Christel, Giggi Udén, and Ania Willman. "Outcomes of evidence-based clinical practice guidelines: A systematic review." International Journal of Technology Assessment in Health Care 20, no. 4 (November 2004): 427–33. http://dx.doi.org/10.1017/s026646230400131x.
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Objectives: This study aimed to investigate whether evidence-based clinical practice in health care improves outcomes for patients, personnel, and/or organizations.Methods: A systematic review of studies was conducted with various quantitative and qualitative methods up to the Spring of 2002. Protocols were used in quality assessment. Data synthesis is descriptive in a narrative form.Results: Of 305 assessed articles, eight studies were included. The outcomes in the included studies were related to the experiences of patients and personnel and to organization concerning changed patient care and resource utilization. Because the included studies are heterogeneous in design, focus of research area, and scientific quality, the scientific foundation for the findings is weak. There is some support that evidence-based clinical practice guidelines, when put to use, improve outcomes (i) for patients—less likelihood of showing worsening of skin condition and disruption of skin condition improves more rapidly for infants; (ii) for personnel—support in daily work situation; and (iii) for organizations—decreased admission rates and length of stay, less resource utilization and reduced costs.Conclusions: There is a need for further research as the findings are based on a rather limited number of studies. There is a tendency toward support for the idea that outcomes improve for patients, personnel, or organizations if clinical practice in health care is evidence-based, that is, if evidence-based clinical practice guidelines are used, although these findings could be specific to the settings and context of the studies reported in this systematic review.
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Malterud, Kirsti. "The Impact of Evidence-Based Medicine on Qualitative Metasynthesis: Benefits to be Harvested and Warnings to be Given." Qualitative Health Research 29, no. 1 (August 30, 2018): 7–17. http://dx.doi.org/10.1177/1049732318795864.
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Qualitative metasynthesis, developed as an interpretative and inductive methodology, is increasingly influenced by standards from evidence-based medicine, established as a strategy to support policy decisions and guidelines. Currently, principles and procedures from the format developed for systematic reviews are often applied for review and synthesis of all kinds of evidence, including results from qualitative studies. In this article, I substantiate these claims, discussing benefits to be harvested and warnings to be given when qualitative metasynthesis approaches the evidence-based medicine methodology. Situating my exploration in the context of clinical practice, I contrast missions and values of these methodologies regarding review and synthesis of research literature, highlighting potential mismatches between ontology and epistemology, emphasizing challenges regarding sample, analysis, and transferability. Approving systematic and transparent strategies as generic for such purposes, I warn against the idea that methodology developed for evidence-based medicine is a universal gold standard for synthesis of research evidence.
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Nunn, Jack, and Steven Chang. "What are Systematic Reviews?" WikiJournal of Medicine 7, no. 1 (2020): 5. http://dx.doi.org/10.15347/wjm/2020.005.
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Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question. While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively. Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine, and a review of existing studies is often quicker and cheaper than embarking on a new study. While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful. Systematic reviews may examine clinical tests, public health interventions, environmental interventions, social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations. An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.
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Nunn, Jack, and Steven Chang. "What are Systematic Reviews?" WikiJournal of Medicine 7, no. 1 (2020): 4. http://dx.doi.org/10.15347/wjm/2020.004.
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Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question.[1] While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively.[2] Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine,[3] and a review of existing studies is often quicker and cheaper than embarking on a new study. While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful.[4] Systematic reviews may examine clinical tests, public health interventions, environmental interventions,[5] social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations.[6][7] An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.
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Lekan, Deborah A., Susan K. Collins, and Audai A. Hayajneh. "Definitions of Frailty in Qualitative Research: A Qualitative Systematic Review." Journal of Aging Research 2021 (June 2, 2021): 1–20. http://dx.doi.org/10.1155/2021/6285058.
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The purpose of this qualitative systematic review was to examine how frailty was conceptually and operationally defined for participant inclusion in qualitative research focused on the lived experience of frailty in community-living frail older adults. Search of six electronic databases, 1994–2019, yielded 25 studies. Data collection involved extracting the definition of frailty from the study aim, background, literature review, methods, and sampling strategy in each research study. Quality appraisal indicated that 13 studies (52%) demonstrated potential researcher bias based on insufficient information about participant recruitment, sampling, and relationship between the researcher and participant. Content analysis and concept mapping were applied for data synthesis. Although frailty was generally defined as a multidimensional, biopsychosocial construct with loss of resilience and vulnerability to adverse outcomes, most studies defined the study population based on older age and physical impairments derived from subjective assessment by the researcher, a healthcare professional, or a family member. However, 13 studies (52%) used objective or performance-based quantitative measures to classify participant frailty. There was no consistency across studies in standardized measures or objective assessment of frailty. Synthesis of the findings yielded four themes: Time, Vulnerability, Loss, and Relationships. The predominance of older age and physical limitations as defining characteristics of frailty raises questions about whether participants were frail, since many older adults at advanced age and with physical limitations are not frail. Lack of clear criteria to classify frailty and reliance on subjective assessment introduces the risk for bias, threatens the validity and interpretation of findings, and hinders transferability of findings to other contexts. Clear frailty inclusion and exclusion criteria and a standardized approach in the reporting of how frailty is conceptually and operationally defined in study abstracts and the methodology used is necessary to facilitate dissemination and development of metasynthesis studies that aggregate qualitative research findings that can be used to inform future research and applications in clinical practice to improve healthcare.
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Majid, Umair, and Meredith Vanstone. "OP119 Appraising Qualitative Research For Qualitative Evidence Syntheses." International Journal of Technology Assessment in Health Care 34, S1 (2018): 44–45. http://dx.doi.org/10.1017/s0266462318001435.
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Introduction:The growth of the evidence-based policy movement sought to determine how to better assess and incorporate qualitative evidence in clinical practice and policy development. The question engendered was not whether qualitative research is valuable but how researchers can enhance its rigor. From this discussion arose over one hundred appraisal tools for the quality appraisal process of qualitative studies. For those without a deep familiarity with the qualitative research paradigm, navigating through the breadth of tools to find the most suitable tool for the task is a cumbersome process. This presentation will review the descriptive characteristics of available quality appraisal tools for assessing the quality of primary qualitative studies in qualitative evidence syntheses (QES). This presentation will also offer a critical discussion on the use of reflexivity as a de facto quality criterion, and how methodological reporting may influence the application of quality criteria in QES.Methods:We conducted a systematic search to identify quality appraisal tools of qualitative research designed for use in QES. This search built upon the work of Santiago-Delefosse and colleagues by extending their search to 2016.Results:We identified eight appraisal tools intended for use in the quality appraisal process of a QES. We provide a description of the structure, content, objectives, and philosophies of tools followed by considerations concerning their historical antecedents, common patterns regarding structure, content, and purpose, and the implications of these patterns on the QES process.Conclusions:Quality appraisal of qualitative research is an important step in QES, and there have been a proliferation of tools for this purpose. By providing an overview of available tools detailing their intent and strengths, this presentation will assist those engaging in QES to choose an appropriate tool for their work.
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Chesnel, Mary Jo, Maria Healy, and Jenny McNeill. "Experiences that influence how trained providers support women with breastfeeding: A systematic review of qualitative evidence." PLOS ONE 17, no. 10 (October 14, 2022): e0275608. http://dx.doi.org/10.1371/journal.pone.0275608.
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Introduction There is a need to improve breastfeeding support interventions as although many are evidence-based, a sequential increase in breastfeeding rates is not evident. It is crucial to understand why the implementation of evidence-based guidelines in practice does not always translate to positive experiences for women and improve breastfeeding rates. This systematic review aims to synthesise breastfeeding support experiences of trained support providers and their impact on breastfeeding support practices. Methods A strategy was developed to search seven databases including Medline and CINAHL and grey literature for qualitative studies. Studies eligible for inclusion reported professional and trained peer experiences of supporting women to breastfeed. PRISMA guidelines were followed and included studies were quality appraised using the CASP Qualitative Checklist. A thematic synthesis of included studies was undertaken and confidence in the review findings was assessed using the CERQual tool. The study protocol, registered in the International Prospective Register of Systematic Reviews PROSPERO registration number: CRD42020207380, has been peer reviewed and published. Findings A total of 977 records were screened, which identified 18 studies (21 papers) eligible for inclusion comprising 368 participants. Following quality appraisal, all studies were deemed suitable for inclusion. The thematic synthesis resulted in four analytical themes: 1) A personal philosophy of breastfeeding support 2) Teamwork and tensions in practice 3) Negotiating organisational constraints and 4) Encounters with breastfeeding women. Findings demonstrated that a range of experiences influence practice, and practice evolves on continued exposure to such experiences. The potential of each experience to facilitate or inhibit breastfeeding support provision is fluid and context specific. Conclusions Experiences, as named above, are modifiable factors contributing to the development of a philosophy of breastfeeding support based on what the provider believes works and is valuable in practice. Further research is required into the range of factors which underpin context-specific breastfeeding support practice, to improve both women’s experiences and intervention effectiveness.
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Carter, Bronwyn J. "Evidence-based decision-making: practical issues in the appraisal of evidence to inform policy and practice." Australian Health Review 34, no. 4 (2010): 435. http://dx.doi.org/10.1071/ah09778.
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Objective. To highlight the differences between a systematic review of the literature and a systematic review of the best available evidence; to discuss practical issues in the appraisal of evidence to inform public health policy and practice; and to make recommendations for next steps in the development of evidence-based decision making in public health. Data sources and selection. Literature and other sources were reviewed including the subject reading list, recommended texts and websites for the La Trobe University postgraduate subject Evidence Based Public Health Practice 2007 and other relevant sources identified. Data extraction and synthesis. Relevant opinions were extracted to summarise debate in relation to definitions of evidence, usefulness of systematic reviews, tools for critical appraisal and other practical issues in the translation of evidence into practice. Conclusions. Evidence relevant to decisions regarding public health policy and practice may include evidence from the literature including experimental and observational studies as well as other sources, including policies and opinions of stakeholders. Further development of skills and approaches to the critical appraisal of evidence are required. Recommendations include: mapping of Australian competencies to public health education; development of national guidelines to inform the appraisal of evidence for public health decision making; and promotion of leadership and education in evidence-based approaches, discussion and debate in relation to definitions of evidence, and public health research that generates the best possible evidence. What is known about the topic? Systematic reviews are a well recognised tool for the critical appraisal of evidence to inform decision making. There is a lack of agreement about what constitutes valid evidence for inclusion in such reviews and many policy makers have no training or qualifications in the use of systematised approaches to the critical appraisal of evidence from a range of sources to inform decisions. Approaches to critical appraisal of evidence and skills in appraisal of evidence and evidence-based decision making require further development. What does this paper add? This paper reviews current opinions on what constitutes valid evidence and discusses important differences between a systematic review of the literature as distinct from a systematic review of available evidence. The desirable approach is recognised as the utilisation of the best available evidence from a range of sources to inform decision making, including evidence from observational studies including qualitative data, as well as contextual and colloquial evidence. This paper calls for: mapping of Australian competencies to public health education; development of national guidelines to inform the appraisal of evidence for public health decision making; and the promotion of leadership and education in evidence-based approaches, discussion and debate in relation to definitions of evidence and the promotion of public health research that generates the best possible evidence. What are the implications for practitioners? This paper calls upon practitioners to further develop skills in critical appraisal of evidence from a range of sources to inform policy and practice, and to foster collaborative partnerships between researchers, policy makers, educators, managers and clinicians.
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Brice, Anne, and Andrew Booth. "Practical issues in creating an evidence base for Library and Information Practice." Library and Information Research 30, no. 94 (June 27, 2013): 52–60. http://dx.doi.org/10.29173/lirg272.
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What are the practical issues in creating a knowledge
base for the library and information profession? ln this
article the authors explore this topic from a practitioner-researcher perspective in order to identify the issues which arise from undertaking research, informed by experiences when conducting a qualitative systematic review.
The paper identifies barriers to using research, as
perceived by library and information professionals, and
discusses general issues encountered when undertaking research as a practitioner.
It reports the experiences of conducting a systematic review of qualitative research in the area of critical appraisal skills, a review spanning several disciplines. The authors select several factors of particular importance to illustrate the specific challenges of creating an evidence base in library and information practice. They highlight many examples of pitfalls and difficulties, but also the payback and rewards, of doing research.
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Hawkins, Melanie, Gerald R. Elsworth, and Richard H. Osborne. "Questionnaire validation practice: a protocol for a systematic descriptive literature review of health literacy assessments." BMJ Open 9, no. 10 (October 2019): e030753. http://dx.doi.org/10.1136/bmjopen-2019-030753.
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IntroductionContemporary validity testing theory holds that validity lies in the extent to which a proposed interpretation and use of test scores is justified, the evidence for which is dependent on both quantitative and qualitative research methods. Despite this, we hypothesise that development and validation studies for assessments in the field of health primarily report a limited range of statistical properties, and that a systematic theoretical framework for validity testing is rarely applied. Using health literacy assessments as an exemplar, this paper outlines a protocol for a systematic descriptive literature review about types of validity evidence being reported and if the evidence is reported within a theoretical framework.Methods and analysisA systematic descriptive literature review of qualitative and quantitative research will be used to investigate the scope of validation practice in the rapidly growing field of health literacy assessment. This review method employs a frequency analysis to reveal potentially interpretable patterns of phenomena in a research area; in this study, patterns in types of validity evidence reported, as assessed against the criteria of the 2014Standards for Educational and Psychological Testing, and in the number of studies using a theoretical validity testing framework. The search process will be consistent with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Outcomes of the review will describe patterns in reported validity evidence, methods used to generate the evidence and theoretical frameworks underpinning validation practice and claims. This review will inform a theoretical basis for future development and validity testing of health assessments in general.Ethics and disseminationEthics approval is not required for this systematic review because only published research will be examined. Dissemination of the review findings will be through publication in a peer-reviewed journal, at conference presentations and in the lead author’s doctoral thesis.
Dissertations / Theses on the topic "Qualitative research; systematic review; evidence-based practice"
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Garside, Ruth. "A comparison of methods for the systematic review of qualitative research : two examples using meta-ethnography and meta-study." Thesis, University of Exeter, 2008. http://hdl.handle.net/10036/116289.
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Systematic reviews and meta-analyses have been a central pillar of evidence-based practice and policy-making in healthcare over recent years. Traditionally, this has focused on effectiveness evidence from trials.. There is increasing understanding, however, that other study designs also provide essential information and this has led to interest in developing ways to review and synthesis such evidence. Qualitative research has unique potential to illuminate the patient experience. This research has three aims: 1) To review and compare the proposed methods of systematic review and synthesis of qualitative research. 2) To develop and assess two methods of systematic review and synthesis of qualitative research. 3) To compare these two methods and suggest how they might be used in a policy-making context. In addressing these aims, this thesis substantially contributes to debates about the purpose and practice of systematic review and synthesis of qualitative research, particularly in the context of health technology assessment and related pOlicy-making. I undertake a unique critical comparison of the methods suggested for reviewing and synthesising qualitative research, based on their approach to key stages of systematic review. This is used to produce a comprehensive framework for good practice~ I use the framework in two systematic reviews, one about heavy menstrual bleeding using meta-ethnography, and one about hysterectomy using meta-study. These two reviews allow a comparison of the two methods, and in particular explore the impact of expanding the meta-ethnography approach through meta-study, which adds explicit steps to assess the impact of study methodology and theory on findings. The ability of meta-study to unpack the procedures and theories that produce particular findings is key and illuminates the importance of theory in systematic reviews of qualitative research. Through the two systematic reviews, my thesis also contributes to understanding of these reproductive health topic areas through the creation of new insights and concepts from the synthesis. The synthesis of heavy menstrual bleeding studies produced a detailed patient illness model based on women's experiences. In addition, it allowed an understanding of elements that contribute to women's certainty or uncertainty about whether or not their periods could be seen as problematic and requiring medical help. This helps to establish the limitations of the medical model for doctors, as well as women who suffer from heavy menstrual bleeding. The synthesis of hysterectomy studies produced a detailed description of the journey that women make to, and through, hysterectomy, based on their experiences. I also created a theoretical framework, which shows that hysterectomy needs to be understood in the context of personal, physical experiences, together with sociocultural forces that affect the way in which hysterectomy is experienced, and that the interaction of these micro- and macro-concerns mediate through, and affect, relationships with key other people. Methodology affected the research questions posed and the conclusions of research. Comparing the two methods of review and synthesis showed the importance of taking account of the methods and theories that produce research findings. However this additional detail may be at the expense of certainty and requires additional resources.
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Abdullah, Ghadah Mubarak. "Mentoring as a Knowledge Translation Intervention to Inform Clinical Practice: A Multi-Methods Study." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32497.
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Background: Mentoring is an intervention for implementing evidence into practice, but little is known about this intervention. The overall aim of this dissertation was to examine mentoring as a knowledge translation (KT) intervention to inform clinical practice.
Methods: 1) A systematic review was used to determine the effectiveness of mentoring as a KT intervention. 2) An interpretive descriptive qualitative study was conducted to explore the use of mentoring in the Registered Nurses' Association of Ontario’s Best Practice Guidelines Implementation/ Knowledge Transfer Fellowship program.
Findings: 1) Of 10,669 citations from 1988 to 2012, 10 studies were eligible. Findings showed that mentoring alone (n = 1 study) improved one behavioral outcome. When mentoring was used as part of a multi-faceted intervention (n = 9), there were various effects on knowledge, beliefs/attitudes, use of research evidence in clinical practice, and the impacts on healthcare professionals, patients and organizations. 2) Qualitative interviews with 6 fellows, 8 mentors and 4 program leaders revealed that mentoring involved building relationships, establishing a learning plan, and using teaching and learning activities. Mentors were described as accessible, dedicated, and having expertise; fellows were described as dedicated, self-directed, and having mixed levels of expertise. Mentoring was described as positively impacting upon mentoring relationships, fellows, mentors, and organizations. Participants reported no negative outcomes.
Conclusion: Mentoring was used as a KT intervention to support the implementation of evidence into clinical practice. The systematic review and qualitative study findings informed the Mentoring for Guideline Implementation model. Mentoring involved mentees selecting more experienced mentors who provided individualized support based on mentees’ learning needs, which resulted in mutual benefits for mentees and mentors. Future research is required to validate this new mentoring model, develop an instrument to measure the mentor-mentee relationship, and evaluate the effectiveness of mentoring as a KT intervention for guideline implementation in nursing.
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Harden, Angela. "'Qualitative' research, systematic reviews, and evidence-informed policy and practice." Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/10019291/.
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This thesis makes a distinctive contribution to debates about how to include and quality assess 'qualitative' research in systematic reviews. It analyses sets of quality criteria, assesses the impact of study quality on findings and compares 'quantitative' and 'qualitative' perspectives on quality. The research consists of a review of the literature and three new methodological studies. The first study surveyed and evaluated quality assessment tools, the second analysed the development of a new tool, and the third examined the relationship between the quality of 'qualitative' research and the findings of systematic reviews. A large number of different quality criteria have been proposed for 'qualitative' research but assessment tools represent 'good practice' guides rather than aids to distinguish between 'good' and 'bad' studies. Continuous funding, a policy-focussed context, and a multi-disciplinary team which viewed research questions as drivers for quality assessment were important factors for developing a unique tool which did help to distinguish between studies. There was no straightforward relationship between study quality and the findings of reviews. However, excluding lower quality studies had little impact on review findings. Studies which made the biggest contribution to reviews were those with appropriate methods for the review question and findings displaying conceptual depth. In contrast to procedures for 'quantitative' research, engaging with study findings as well as study methods is important for assessing fully the quality of 'qualitative' research. This thesis generates important empirical evidence for debates about how to assess the quality of 'qualitative' research. It shows how standard quality assessment protocols need to be altered better to fit 'qualitative' research, reveals how study quality can impact on review findings and demonstrates some problems with the terms 'qualitative' and 'quantitative'. Future debate in this area should focus on how to identify reliable answers to questions about intervention process, context and need.
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Ring, Nicola A. "A critical analysis of evidence-based practice in healthcare : the case of asthma action plans." Thesis, University of Stirling, 2013. http://hdl.handle.net/1893/13061.
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Evidence-based practice is an integral part of multi-disciplinary healthcare, but its routine clinical implementation remains a challenge internationally. Written asthma action plans are an example of sub-optimal evidence-based practice because, despite being recommended, these plans are under-issued by health professionals and under-used by patients/carers. This thesis is a critical analysis of the generation and implementation of evidence in this area and provides fresh insight into this specific theory/practice gap. This submission brings together, in five published papers, a body of work conducted by the candidate. Findings report that known barriers to action plan use (such as a lack of practitioner time) are symptomatic of deeper and more complex underlying factors. In particular, over-reliance on knowledge derived from randomised controlled trials and their systematic review, as the primary and sole source of evidence for healthcare practice, hindered the implementation of these plans. A lack of evidence reflecting the personal experience of using these plans in the real world, rather than in trial settings, contributed to a mismatch between what patients/carers want from asthma action plans and what they are currently being provided with by professionals. This submission illustrates the benefits of utilising a broader range of knowledge as a basis for clinical practice. The presented papers report how new and innovative research methodologies (including meta-ethnography and cross-study synthesis) can be used to synthesise individual studies reporting the personal experiences of patients and professionals and how such findings can then be used to better understand why interventions can be implemented in trial settings rather than everyday practice. Whilst these emerging approaches have great potential to contribute to evidence-based practice by, for example, strengthening the ‘weight’ of experiential knowledge, there are methodological challenges which, whilst acknowledged, have yet to be fully addressed.
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Porritt, Kylie. "A discursive analysis of contemporary literature examining qualitative research findings in evidence-based health care." Thesis, 2011. http://hdl.handle.net/2440/69869.
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The systematic review has become the ‘gold standard’ of evidence. Historically the systematic review has focused on effectiveness and as such the aggregation of results from randomised controlled trials. However health care questions are often complex requiring different research approaches to yield appropriate answers. It is acknowledged that not all research questions are amenable to the results of RCTS and as such there is now a shift towards understanding the need to incorporate research findings that acknowledge social and cultural concerns. This shift has resulted in an increased use of qualitative research findings as evidence and more specifically the systematic review of qualitative research findings. While still a relatively new area of research, the methods surrounding qualitative systematic review are fast developing. To date there are many views and debates on how this type of research should be performed. In order to gain a deeper level of understanding of these positions a discursive analysis informed by Foucault was undertaken on contemporary literature. Incorporating Foucault’s archaeological and genealogical aspects to analysis three distinct discursive formations related to the incorporation of qualitative systematic review into evidence-based practice is revealed. History of the present: a voice silenced examines the discourses surrounding the evidence-based revolution lack of reference to incorporating qualitative research findings. Rise of the silenced voice examines the discourses around positioning qualitative research findings into evidence-based practice. The final formation, Building Blocks to systematic review examines all the discourses surrounding the elements of conducting a qualitative systematic review. Finally the researcher concludes that all approaches to synthesising qualitative research are useful and have a place within health care but only reviews that follow the Five Stages of Systematic Review can be given the label of being a ‘systematic review’. Only those methods that detail an explicit, well defined question, perform a comprehensive search for research, critically assess the quality of research papers, extract and aggregate the findings of the included research papers can be given the label of being a qualitative systematic review.Thesis (Ph.D.) -- University of Adelaide, The Joanna Briggs Institute, 2011
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Ramis, Mary-Anne. "The experience of being an advanced practice nurse within Australian acute care settings: a systematic review of qualitative evidence." Thesis, 2013. http://hdl.handle.net/2440/81484.
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Background: Shortages of health care professionals and an ageing nursing workforce are some of the factors leading to the creation and evolution of many new nursing roles. Advanced practice nurses across the globe are working under many different titles and within various contexts, in order to address gaps within current health care systems. Comparison of roles between countries is difficult and possibly inappropriate due to Australia’s unique environmental and demographic characteristics. A context-specific systematic review on the qualitative evidence of the experience of being an advanced practice nurse in Australia has not been undertaken previously, however it is imperative for nursing managers and leaders to understand the complexities of advanced nursing roles in order to effectively utilise and retain these experienced and valuable nurses. Aim: This study aims to provide deeper understanding of the experience of being an advanced practice nurse working in Australian acute settings and identify personal, professional and organisational factors influencing experiences. Methods: A three-step search strategy, following the Joanna Briggs Institute method was used to identify published and unpublished interpretive studies meeting set inclusion criteria. Critical appraisal and data extraction were completed the Joanna Briggs Institute Qualitative Assessment and Review Instruments. Results: Following the search and appraisal process, four studies were assessed as meeting the inclusion criteria and from these, 216 findings were extracted. Six meta-syntheses under the headings of expert knowledge, confidence, education, relationships, negative experiences and patient centered experience were formed from the findings. Conclusion: This review has increased our understanding about the experience of being an advanced practice nurse in Australian acute care settings and provided evidence of the role being multifactorial and complex. The patient is central to the APN experience but organisational factors impact and influence their experience also. Health care organisations must be aware of the impact they have on the nurse’s experience if they are to commit to nurse retention and patient safety. Nurses must continue to improve articulating their experiences in order to quantify the more intangible aspects of their practice. Implications: There is a pragmatic aspect to this review as implications for practice are specific to the functioning of the advanced practice nurse in the Australian acute care environment. The complexity of the role has been highlighted which may assist to inform future research into other aspects of APN practice.Thesis (M.Phil.) -- University of Adelaide, School of Nursing, 2013
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Camargo, Siglia. "Behaviorally-Based Interventions for Improving Social Interaction Skills of Children with ASD in Inclusive Settings: A Systematic Review and Meta-Analysis." Thesis, 2012. http://hdl.handle.net/1969.1/148106.
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Students with autism spectrum disorders present deficits in social interaction skills that may prevent their successful inclusion in general education placements. Considering the increasing number of children with autism spectrum disorders (ASD) being educated in inclusive settings and recent requirements on the use of research-based interventions in schools, the purposes of this study were (1) to evaluate the quality of single-case research and determine whether behaviorally-based interventions to improve social interaction skills of children with ASD in inclusive settings can be considered evidence-based practices and (2) to conduct a meta-analysis investigating whether specific factors such as participants' age, behavioral components used in the intervention, target social interaction skills, intervention implementer, and peer training moderate effectiveness of the interventions.
Specific criteria for quality of single-case research were used to classify studies according to their certainty of evidence. Tau-U, a non-parametric index of effect size in single-case research, was used to measure the intervention's magnitude of change on target outcomes. Differences between levels of the moderators were analyzed using statistical significance test (p = .05) through the use of 83.4% confidence intervals. Results indicate that the use of behaviorally-based interventions to improve social interaction skills of students with ASD in inclusive settings can be considered evidence based practices. In addition, the interventions produced overall high effect size, indicating their effectiveness based on studies meeting minimum standards of methodological quality. More specifically, the interventions are demonstrated to be effective for preschool and elementary school children between the ages of 2 and 10 years. Studies targeting social interaction initiations or responses in isolation were more effective than studies focusing on both skills. While interventions using planned reinforcement were shown to be more effective, no differential effects were found regarding the use of planned modeling. No differences were found regarding intervention implementer. Finally, the use of peer training did not appear to increase effectiveness of the behaviorally-based social skill interventions. The results and their implications for practice and future research are discussed.
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Baskerville, Neill. "Systematic Review of Practice Facilitation and Evaluation of a Chronic Illness Care Management Tailored Outreach Facilitation Intervention for Rural Primary Care Physicians." Thesis, 2009. http://hdl.handle.net/10012/4298.
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Nearly two decades of research on translating evidence-based care guidelines into practice has resulted in a considerable body of primary and secondary evidence about guideline implementation strategies and the individual, organizational and environmental challenges associated with closing the evidence to practice gap in primary care. Interventions to improve professional performance are complex and a disentangling of the various independent, intervening and constraining variables is required in order to be able to design and implement interventions that can improve primary care practice performance. The PRECEDE-PROCEED planning model (Green & Kreuter, 1999) provides a step-wise theoretical framework for understanding the complexity of causal relationships among the variables that affect the adoption of evidence-based practice and may assist in the design and implementation of practice-based interventions.
Knowledge of an evidence-based practice guideline is important, but a consensus has emerged that having knowledge is rarely sufficient to change practice behaviour. Didactic education or passive dissemination strategies are ineffective, whereas interactive education, reminder systems and multifaceted interventions tailored to the needs of the practice are effective. Outreach or practice facilitation is a proven effective multifaceted approach that involves skilled individuals who enable others, through a range of tailored interventions, to address the challenges in implementing evidence-based care guidelines within the primary care setting. The challenges to implementing evidence-based chronic illness care practice guidelines are thought to be similar to the other contextual, organizational and individual behavioural challenges associated with the uptake of research findings into practice. A multifaceted guideline implementation strategy such as practice facilitation may be well-suited to improving the adoption of these guidelines within rural primary care settings. However, research has not systematically reviewed, through meta-analysis, the published practice facilitation trials to determine overall effects and an implementation research study of practice facilitation that has considered fidelity of implementation within the rural Ontario setting for a complex practice guideline such as chronic illness management has not been done.
The systematic review in the thesis incorporated an exploratory meta-analysis of randomized and non-randomized controlled trials of interventions targeted towards implementing evidence-based practice guidelines through practice facilitation, and was conducted to gain an understanding of the overall effect of practice facilitation and the factors that moderate implementation success. The results were the identification of an improvement overtime in the methodological rigour of practice facilitation implementation research based on a critical appraisal of methods, a significant moderate overall effect size of 0.54 (95% CI 0.43 – 0.65) for 19 good quality practice facilitation intervention studies and several significant effect size modifiers; notably, tailoring to the needs of the practice, using multiple intervention components, extending duration, and increasing the intensity of practice facilitation were associated with larger effect sizes. As more practices were assigned to the practice facilitator, the effect diminished. A significant positive association between the number of PRECEDE predisposing, enabling and reinforcing strategies employed by the facilitator and the effect size was detected.
The implementation research study utilized mixed methods for data collection as part of an embedded case study of four rural primary care practices to determine the implementation fidelity of the practice facilitation of chronic illness care planning and the factors that impeded and contributed to implementation success. The feasibility of and potential cost savings of practice facilitation via videoconferencing was also implemented for two of the practices. For those practices that successfully implemented care planning, fidelity was achieved for the implementation of care plans. On the other hand, the dosage, duration, component delivery of the practice facilitation intervention was low in comparison to other published studies, and tailoring of the intervention to the practice was inconsistent. Based on the qualitative analysis of physician interviews, the moderating factors for successful implementation were categorized into the broad themes of pessimism and tempered optimism. Pessimistic physicians were unsuccessful at implementation, lacked a willingness to engage and were uncomfortable with the patient-centred approach to chronic illness care. Optimists were positive about the psychosocial, patient-centred assessment aspects of the chronic illness care protocol and provided anecdotes of success in resolving patient problems. However, this was tempered as both pessimists and optimists reflected on the time intensive aspect of the protocol and the unlikelihood of widespread implementation without additional supports. Participating physicians were satisfied with the facilitator and the videoconferencing experience, and the intervention cost analysis revealed opportunities for cost saving via the use of videoconferenced facilitation. Improvements to the intervention suggested by participants included integrating chronic illness management with medical information systems, involving other health disciplines, and forming networks of community health resources and support services for health providers and patients.
This work has demonstrated that although practice facilitation can successfully result in moderate significant improvements in practice behaviour, it is not necessarily singularly effective in all contexts or for all targeted behaviours. A complex practice guideline such as the chronic illness care management model is unlikely to be adopted in the current context of primary care in rural Ontario and as a consequence to have any impact on the health of chronically ill patients without further intervention supports, adaptation, and implementation research undertaken to demonstrate successful execution of chronic illness care management. Alternative care delivery models are required to address barriers and improve the delivery of chronic illness care management.
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Váchová, Veronika. "Informační podpora medicíny založené na důkazu na Psychiatrické klinice 1. Lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice v Praze." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-404745.
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The thesis focuses on the use of Evidence Based Medicine (EBM) methods and principles at the Psychiatric Clinic of the First Faculty of Medicine of Charles University and the General University Hospital in Prague. There is a theoretical introduction to EBM - its origin and development, EBM information resources as well as general basic principles of this approach to work with clinical evidence. Part of this work introduces the history and current activities of the Psychiatric Clinic and the related Psychiatric Association of the Czech Medical Association of J. E. Purkyně. The practical part of the thesis describes the preparation of research and its results. Based on semi-structured interviews with physicians of the Psychiatric Clinic, the results of this research represents their current attitude towards EBM and use of EBM methods in their daily work. The aim of the thesis is also a proposal to raise awareness of EBM information sources in the form of information materials and educational seminars.
Books on the topic "Qualitative research; systematic review; evidence-based practice"
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Royal Society of Medicine (Great Britain), ed. Systematic reviews to support evidence-based medicine: How to review and apply findings of healthcare research. 2nd ed. London: Hodder Annold, 2011.
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1953-, Mulrow Cynthia D., and Cook Deborah 1960-, eds. Systematic reviews: Synthesis of best evidence for health care decisions. Philadelphia, Pa: American College of Physicians, 1998.
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Making Sense of Evidence-Based Practice for Nursing: An Introduction to Quantitative and Qualitative Research and Systematic Reviews. Routledge, 2022.
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Making Sense of Evidence-Based Practice for Nursing: An Introduction to Quantitative and Qualitative Research and Systematic Reviews. Routledge, 2022.
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Evans, Debra. Making Sense of Evidence-Based Practice for Nursing: An Introduction to Quantitative and Qualitative Research and Systematic Reviews. Taylor & Francis Group, 2022.
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Evans, Debra. Making Sense of Evidence-Based Practice for Nursing: An Introduction to Quantitative and Qualitative Research and Systematic Reviews. Taylor & Francis Group, 2022.
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Evans, Debra. Making Sense of Evidence-Based Practice for Nursing: An Introduction to Quantitative and Qualitative Research and Systematic Reviews. Taylor & Francis Group, 2022.
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Burns, Tom, and Mike Firn. Research and development. Edited by Tom Burns and Mike Firn. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198754237.003.0029.
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This chapter covers the spectrum of routine monitoring, audit, service evaluation, and formal research. Routine monitoring is an essential task for all mental health professionals, and techniques to make it more palatable are explored, including using routine data for clinical supervision and monitoring team targets. Regular audit is described as an essential tool for logical service development and quality improvement. In the discussion of research, the importance of choosing the correct methodology and of paying attention to detail are stressed. In community psychiatry, sampling bias, regression to the mean, and the Hawthorne effect pose important risks. The hierarchy of research methods is outlined with randomized controlled trials (RCTs) at the top, preferably with either single- or double-blinding. Careful statistics and systematic reviews support evidence-based practice. In addition to experimental quantitative trials, there is a place for cohort and case control trials, as well as for qualitative trials to generate hypotheses.
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Christine, Webb, and Roe Brenda H, eds. Reviewing research evidence for nursing practice: Systematic reviews. Oxford: Blackwell Pub., 2007.
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(Editor), Christine Webb, ed. Reviewing Research Evidence for Nursing Practice: Systematic Reviews. Wiley-Blackwell, 2007.
Find full textBook chapters on the topic "Qualitative research; systematic review; evidence-based practice"
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Bronson, Denise E., and Tamara S. Davis. "Systematic Reviews of Qualitative Research." In Finding and Evaluating EvidenceSystematic Reviews and Evidence-Based Practice, 58–75. Oxford University Press, 2011. http://dx.doi.org/10.1093/acprof:oso/9780195337365.003.0025.
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Flemming, Kate. "Qualitative research." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 1289–94. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0122.
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This chapter outlines the importance of qualitative research as a method to provide answers to clinical questions arising in palliative medicine. Rather than being a chapter about how to ‘do’ qualitative research, it is a chapter that seeks to outline the role and purpose of qualitative research for palliative care by looking at the kind of questions qualitative research can answer, exploring qualitative research and its relationship to evidence-based practice, the role of qualitative research in the evaluation of complex interventions, and the importance to palliative medicine of undertaking systematic reviews of qualitative research. It addresses practical aspects of searching for qualitative research and how to assess for methodological strengths and limitations. In exploring these issues, it firmly establishes a place for qualitative research within evidence-based practice and for palliative medicine in particular.
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"Evidence-based psychiatry." In Oxford Handbook of Psychiatry, edited by David Semple and Roger Smyth, 107–28. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199693887.003.0004.
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Introduction Finding and appraising the evidence Systematic reviews (SRs) of RCTs Randomized controlled trials (RCTs) Case–control studies Cohort studies Diagnostic studies Qualitative studies Economic studies Applying the evidence to patients Measuring performance and implementing evidence-based practice Evidence-based medicine (EBM) is the application of research evidence to medical treatment decisions. Evidence-based practice aims to integrate the best available research evidence with individual clinical experience....
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Harrison, Paul, Philip Cowen, Tom Burns, and Mina Fazel. "Evidence-based approaches to psychiatry." In Shorter Oxford Textbook of Psychiatry, 119–34. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198747437.003.0006.
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‘Evidence-based approaches to psychiatry’ describes the application of evidence-based medicine (EBM) to psychiatric practice. The chapter covers the key processes in EBM, including the formulation of a clinically relevant question, the systematic search for high-quality evidence and the meta-analytic synthesis of data. It demonstrates how evidence-based approaches to psychiatry have led to important developments showing quantitative effects of different treatments through advanced meta-analysis of data from randomized trials. This has underpinned the development of clinical guidelines that have the aim of improving the reliability and quality of treatments that patients receive. The chapter also describes how meta-analyses should be critically reviewed, as well as their problems and limitations. Not all relevant questions in psychiatric research are susceptible to the quantitative approach offered by EBM, and the chapter also outlines how qualitative methodologies can play a key role in answering important questions related, for example, to the patient experience.
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Coon, Jo Thompson, and Rebecca Abbott. "Critical appraisal." In Practical Psychiatric Epidemiology, 285–302. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198735564.003.0017.
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This chapter provides an introduction to the principles of critical appraisal and explains why critical appraisal skills are important in practice and research. Guidance is provided on how to approach the critical appraisal of different types of study including cross-sectional studies, case–control studies, cohort studies, clinical trials, systematic reviews, and qualitative studies. A worked example is provided at the end of the chapter to illustrate the process. Developing skills in critical appraisal will help readers to assess the credibility, relevance, and value of the results of research and is an essential component of practising evidence-based medicine.
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Streimikiene, Dalia, and Gintare Stankuniene. "Nudges for Enhancing Sustainable Energy Consumption in Households." In Handbook of Research on Novel Practices and Current Successes in Achieving the Sustainable Development Goals, 180–210. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-8426-2.ch009.
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This chapter explores interventions of energy consumption in households and their impacts on behavioural changes by addressing the main behavioural barriers of sustainable energy consumption. The main objectives of this chapter are to identify the importance of nudges in reducing energy consumption and implementation of renewable microgeneration technologies and to develop recommendations for tailor-made interventions. A qualitative research method is applied to analyse the climate change mitigation measures linked to energy consumption in households based on systematic literature review. Traditional economic and regulatory policy tools can be effectively supplemented by nudges; however, more research is necessary in this field.
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Strano, Eugenia, Alessandro Rizzello, and Annarita Trotta. "Evaluation in Impact Investing." In Advances in Finance, Accounting, and Economics, 46–76. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-7998-8501-6.ch003.
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The emergence of impact investing over the past decade has been accompanied by an increased interest of practitioners and scholars in the impact evaluation topic, one of the twofold pillars of the such an innovative financial approach. To contribute to the international debate, this study adopts a qualitative approach by obtaining results from a systematic literature review of extant research. This is useful to 1) identify the current existing impact evaluation approaches adopted in the field and 2) derive an empirical analysis in the impact investing sector with a focus on impact measurement in social impact bonds. The study opens interesting insights into recognizing the potential for the whole impact investing field, deriving both from theory and evidence of impact evaluation practices.
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Mahlangu, Vimbi Petrus. "Quality Assurance and Accreditation in Open and Distance Learning." In Research Anthology on Preparing School Administrators to Lead Quality Education Programs, 1079–97. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-3438-0.ch049.
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The purpose of this chapter is to argue that all open and distance learning (ODL) institutions should carry out quality assurance and accreditation processes in order for students and funders to have confidence in them. It also explains in detail what quality assurance and accreditation entails in ODL. This chapter follows a qualitative approach in understanding quality assurance and accreditation in ODL. Data were collected via literature review. During recent decades, the discourse and practices of systematic quality assurance and quality control have spread around the world, resulting to a great extent in market-based models related to the ideology and policy of neo-liberalism and expressed in economic rationalities such as new public management, total quality management, public choice, and human capital. Quality assurance and accreditation in ODL aims to maintain and raise the quality of education and to guarantee the improvement of its standards.
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Tezel, Ecem, and Heyecan Giritli. "A Scientometric Analysis of Studies in Turkey." In Research Anthology on BIM and Digital Twins in Smart Cities, 533–49. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-6684-7548-5.ch024.
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Recently, architecture engineering and construction (AEC) industry benefits from building information modeling (BIM) as a technology-based development, to enhance collaboration and increase the efficiency of construction projects. After implementing BIM in design and construction phases, developed countries now head towards utilization of BIM in facilities management (FM) processes. As ranking among the leading AEC industries, Turkey not only follows latest developments but also promises valuable potentials for both theoretical and practical improvement of BIM. Based on the studies published in BIM field, this study applies bibliometric review approach to analyze the state-of-the-art situation of the field in Turkey, and determine potential research areas, especially in BIM and FM intersection. Following the systematic literature search that aims to introduce current efforts of Turkish researchers in BIM field, the qualitative analysis categorizes these efforts according to life cycle phases of a construction project and provides a vision on existing knowledge as well as research gaps. Findings of this study point out the important contributions of Turkey to BIM field especially in design and/or construction phases. A prominent conclusion of this study also signals a need for more FM oriented approach in BIM researches.
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Thombs, Brett D., and Roy C. Ziegelstein. "Screening in Cardiovascular Care." In Screening for Depression in Clinical Practice. Oxford University Press, 2009. http://dx.doi.org/10.1093/oso/9780195380194.003.0018.
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There is great interest in screening in cardiovascular settings but little evidence that implementation of screening will affect depression or cardiac outcomes despite the epidemiologic evidence that depression predicts cardiac events and mortality. Since this chapter was accepted, in October 2008 the American Heart Association (AHA) Working Group published a Scientific Advisory recommending that all patients with cardiovascular disease be screened for depression, although this recommendation was not based on a systematic review of the evidence. Several weeks after release of the Scientific Advisory, a systematic review of depression screening in cardiovascular care was published but did not find evidence that patients with cardiovascular disease would benefit from screening for depression. The authors of the review noted that no published trials have assessed whether screening for depression improves depressive symptoms or cardiac outcomes in patients with cardiovascular disease, suggesting that the recommendations of the AHA Scientific Advisory were premature. High rates of depression were first documented among patients with cardiovascular disease (CVD) in the late 1960s. Early research on depression in CVD focused on patients with acute myocardial infarction (AMI) and conceptualized depression as an acute reaction to a catastrophic medical event. In the 1990s, groundbreaking work by Frasure-Smith and colleagues demonstrated a connection between major depression during hospitalization for AMI and subsequent mortality. Since then, many other studies have identified major depression or depressive symptoms as risk factors for mortality and recurrent cardiac events among patients with AMI or unstable angina pectoris (together known as acute coronary syndromes [ACS]) even after controlling for other known risk factors, although not all studies have reported a significant association. Other studies have reported that depression among patients with ACS is related to decreased quality of life and poor adherence to secondary prevention behaviors, including smoking cessation, taking prescribed medications, exercising, and attending cardiac rehabilitation. Less research on the relationship between depression and mortality has been done in other CVD patient groups, although similar links have been reported in studies of patients with congestive heart failure (CHF), for instance.
Conference papers on the topic "Qualitative research; systematic review; evidence-based practice"
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Nwaiwu, Fortune, Meri Duduci, and Felicita Chromjakova. "Assessment of the critical success factors that enable implementation of industry 4.0 concepts in manufacturing companies within the SME sector in the Czech Republic." In Contemporary Issues in Business, Management and Economics Engineering. Vilnius Gediminas Technical University, 2019. http://dx.doi.org/10.3846/cibmee.2019.072.
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Purpose – the research analyses and identifies, factors that influence and have the most impact in achieving a sustainable process management model in the implementation of Industry 4.0 concepts within production based SMEs. Research methodology – the research adopted qualitative and quantitative research. The qualitative approach involved an extensive and systematic review of literature while the quantitative approach involved the use of an online questionnaire used to collect data and analyzed using confirmatory factor analysis to test the measures of the constructs in the proposed conceptual framework. Findings – the result from the research shows the main influencing factor that enables successful implementation of the Industry 4.0 process management model in SMEs. Research limitations – the main research limitation is that the SMEs covered in the quantitative aspect of the research is located in the Czech Republic. It would be interesting to have similar studies conducted in other geographies for comparison purposes. Practical implications – the findings from the study are useful to practitioners and industry stakeholders who intend to develop the right process management model reliant on Industry 4.0 within their SMEs. Originality/Value – the originality/value is based on the combination of a quantitative alongside the qualitative approach in investigating the phenomenon covered in the study.
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Jones, Fiona, Abigail Baker, Raymond A’Court, and Jo Hardy. "Reimagining Information Literacy teaching and learning during the COVID-19 pandemic: Research and evidence-based practice skills training redesigned for online delivery." In ASCILITE 2020: ASCILITE’s First Virtual Conference. University of New England, Armidale, 2020. http://dx.doi.org/10.14742/ascilite2020.0132.
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Information literacy teaching and learning for Master of Chiropractic students undertaking systematic reviews was re-envisioned from hybrid to fully online mode due to COVID-19 pandemic restrictions. Collaboration with the academic unit convener informed design and development of appropriate online learning activities and assessment for student achievement of required learning outcomes. Using flipped classroom methodology, a pre-recorded lecture demonstrated research question formulation and advanced database search strategies. Tutorial activities were redesigned for Zoom delivery using breakout rooms to replicate the collaborative aspect of face-to-face tutorials. Learning was supported by a refreshed online research guide, research consultations, and emails. Consultations were delivered via Zoom upon request for more specific advice including question formulation, search terms, choosing appropriate research databases, and advanced database search techniques. Feedback and assessments were positive and review will inform future offerings.
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Jäger-Dengler-Harles, Ingeborg, Tamara Heck, and Marc Rittberger. "Systematic reviews as object to study relevance assessment processes." In ISIC: the Information Behaviour Conference. University of Borås, Borås, Sweden, 2020. http://dx.doi.org/10.47989/irisic2024.
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Introduction. Systematic reviews are a method to synthesise research results for evidence-based decision-making on a specific question. Processes of information seeking and behaviour play a crucial role and might intensively influence the outcomes of a review. This paper proposes an approach to understand the relevance assessment and decision-making of researchers that conduct systematic reviews. Method. A systematic review was conducted to build up a database for text-based qualitative analyses of researchers’ decision-making in review processes. Analysis. The analysis focuses on the selection process of retrieved articles and introduces the method to investigate relevance assessment processes of researchers. Results. There are different methods to conduct reviews in research, and relevance assessment of documents within those processes is neither one-directional nor standardised. Research on information behaviour of researchers involved in those reviews has not looked at relevance assessment steps and their influence in a review’s outcomes. Conclusions. A reason for the varieties and inconsistencies of review types might be that information seeking and relevance assessment are much more complex and researchers might not be able to draw upon their concrete decisions. This paper proposes a research study to investigate researcher behaviour while synthesising research results for evidence-based decision-making.
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Soares, Samantha Lia Ziotti Bohn Gonçalves, Letícia Santana Ferreira Gonçalves, Emily Thauara de Souza, Pollyana Yuri Salles Suguinoshita, Luana Isla Rocha Alves, Anna Mariah R. ibeiro Oliveira, Thalia Castro Souza, and Bárbara Machado Garcia. "Clinical correlation between Migraine and Generalized Anxiety Disorders: a literature review." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.154.
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Background: Migraine and anxiety are common neuro-psychiatric disorders in clinical practice, sharing symptoms and epidemiological factors among themselves. The presence of both pathologies in the same individual is frequently reported in the literature. Objectives: To report the clinical and epidemiological correlations established between generalized anxiety disorder and migraine. Methodology: Systematic review of studies published between 2016 and 2021, exploring the association between generalized anxiety disorders and Migraine. The descriptors “association”, “Migraines” and “Generalized Anxiety Disorder” were used in the LILACS, SCIELO and PUBMED databases. Fourteen articles were selected, mostly dealing with epidemiological studies. Results: Evidence suggests that these pathologies are associated and share common symptoms, pathophysiology and epidemiological factors. Studies corroborate that anxiety and painful sensation are more strongly associated with migraine than with other psychiatric illnesses. It has also demonstrated some characteristics of patients who are predisposed to develop both comorbidities such as smoke, low income and a history of other previous diseases. Common triggering factors such as pain, sleep disorders and stress can also contribute to the association between pathologies. Conclusions: Based on the studies analyzed in full, the high prevalence of both diseases in the same individual highlights the importance of research on the cause and consequence relationship between Anxiety and Migraine, since this is not yet clarified in the medical literature. In addition, paying attention to migraine correlation to generalized anxiety disorder increases the quality of life of the patient in the short and long term, as well as help in the choice of better treatments.
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De Silva, GHAHN, and YG Sandanayake. "Quantity surveyors working from home during COVID-19 pandemic: Does place matter?" In 10th World Construction Symposium. Building Economics and Management Research Unit (BEMRU), University of Moratuwa, 2022. http://dx.doi.org/10.31705/wcs.2022.55.
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COVID-19 pandemic affected people in many ways. To prevent the spread of the virus, governments-imposed travel restrictions. This became the main reason for many sectors to adopt work from home (WFH) concept. Although WFH grew prominently with the COVID-19 pandemic, it was already practiced in several sectors even before the pandemic. However, there was lack of evidence regarding the quantity surveyor’s practice in WFH. This research therefore attempts to investigate how the quantity surveyors WFH during COVID-19 pandemic and factors that affected the successful functioning of their job. To achieve the aim, a mixed method research approach was undertaken. Initially, a comprehensive literature review was carried out and an interview guideline was developed as the data collection instrument. Subsequently, 30 semi-structured interviews were conducted to collect data. Collected qualitative data was analysed through code-based content analysis using NVivo 10 and quantitative data was analysed by using descriptive statistical analysis. Results shows that nature of job role, personal qualities, technology, organization related factors, gender, home-work interface, and economic condition of the country affects the QS’s function during WFH. Further, age, location of home, weather condition, job experience and performance of other employees were identified as factors that have a potential to affect QSs during WFH. This research findings can be used to implement WFH concept effectively to optimise quantity surveyor performance in the construction industry by controlling each factor that affects when QSs WFH
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Schooley, Ben, Akanksha Singh, Sarah Floyd, Stephan Pill, and John Brooks. "Direct Weighting Interactive Design of Patient Preferences for Shared Decision Making in Orthopaedic Practice." In 13th International Conference on Applied Human Factors and Ergonomics (AHFE 2022). AHFE International, 2022. http://dx.doi.org/10.54941/ahfe1002105.
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Patients need the ability to accurately and efficiently communicate their preferences across outcome domains to their healthcare providers.1-7 No existing system provides an efficient and timely approach to collect and communicate patient preferences across outcome domains to support shared decision making (SDM) in orthopaedic practice.2-4,8-19 The overarching goal of this research is to design, build, and test an app that collects baseline patient preferences and health status across orthopaedic outcomes and reports this information to the provider for use in patient care. A core component of the app is a Direct-Weighting (DW) preference assessment approach, originated from our prior research, and applied in a touchscreen based interactive design. It is envisioned that patients will use the app after scheduling a first visit to a surgeon for a new orthopaedic condition. Direct weighting (DW) approaches calculate patient-specific preference weights across outcomes by asking patients to disperse portions of a hypothetical “whole” across outcomes in a manner that reflects a patient’s preferences.20 DW has low respondent burden but it requires respondents to make “implicit” comparisons which may be difficult to conceptualize.20 However, the DW approach has become generally accepted in the quality-of-life literature and it has been shown that patients dividing up pieces of a “pie” across quality-of-life domains yields valid representations of patient preferences across the domains.20-22 However, the DW approach has not been validated with specific clinical scenarios using a clinically focused set of outcomes or by using a mobile software app. Drawing on prior research, we iteratively design and develop the app with input from prior DW research, informaticians, and clinicians. We use a qualitative approach to pilot test the app with 20 first-time visit patients presenting with joint pain and/or function deficiency. Participants were interviewed about their outcome preferences for care, used the app to prioritize outcome preferences, answered interview questions about their experience using the app, and completed a mHealth App Usability Questionnaire (MAUQ). Interview questions focused on the utility and usability of the mobile app for communicating with their provider, and capability of the app to capture their outcome preferences. Results validated five core preference domains, with most users dividing their 100-point allocation across 1-3 domains. The tool received moderate to high usability scores. Patients with older age and lower literacy found the DW approach more difficult in terms of allocating 100 points across 5 domains. Suggestions for DW interface interaction improvement included instantiation of a token/points oriented DW preference scoring methodology rather than a 1-10 sliding scale approach for improved preference weighting cognition and SDM with a provider. As more patient reported outcome (PRO) apps hit the marketplace across a broad spectrum of health conditions, these results provide evidence for a DW approach and interactive design for patients to communicate their treatment preferences to their providers.References:1.Baumhauer JF, Bozic KJ. Value-based Healthcare: Patient-reported Outcomes in Clinical Decision Making. Clin Orthop Relat Res. 2016;474(6):1375-1378.2. Slim K, Bazin JE. From informed consent to shared decision-making in surgery. J Visc Surg. 2019;156(3):181-184.3. Damman OC, Jani A, de Jong BA, et al. The use of PROMs and shared decision-making in medical encounters with patients: An opportunity to deliver value-based health care to patients. J Eval Clin Pract. 2020;26(2):524-540.4. Sorensen NL, Hammeken LH, Thomsen JL, Ehlers LH. Implementing patient-reported outcomes in clinical decision-making within knee and hip osteoarthritis: an explorative review. BMC Musculoskelet Disord. 2019;20(1):230.5. Kamal RN, Lindsay SE, Eppler SL. Patients Should Define Value in Health Care: A Conceptual Framework. J Hand Surg Am. 2018;43(11):1030-1034.6. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Social Science & Medicine. 1999;49(5):651-661.7. Niburski K, Guadagno E, Mohtashami S, Poenaru D. Shared decision making in surgery: A scoping review of the literature. Health Expect. 2020.8. Selten EM, Geenen R, van der Laan WH, et al. Hierarchical structure and importance of patients' reasons for treatment choices in knee and hip osteoarthritis: a concept mapping study. Rheumatology (Oxford). 2017;56(2):271-278.9. Kannan S, Seo J, Riggs KR, Geller G, Boss EF, Berger ZD. Surgeons' Views on Shared Decision-Making. J Patient Cent Res Rev. 2020;7(1):8-18.10. Briffa N. The employment of Patient-Reported Outcome Measures to communicate the likely benefits of surgery. Patient Relat Outcome Meas. 2018;9:263-266.
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King-Berry, Arlene, and Carolene Eslyn Charles. "FACULTY & STUDENT RETENTION: KEEPING OUR HBCU-UDC ALIVE DURING THE COVID-19 PANDEMIC." In International Conference on Education and New Developments. inScience Press, 2021. http://dx.doi.org/10.36315/2021end119.
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There is a national crisis around recruiting and retaining students from HBCUs. The Journal of Blacks in Higher Education surveyed 64 of 100 HBCUs and found that only five of the schools surveyed graduated more than 50 percent of their students. The statistics are startling because HBCUs, some of which date to Reconstruction in the South after the Civil War (widely accepted as the period from 1865 to 1877), ostensibly was designed to improve an underserved community. Despite the large number of freshmen admitted each year to Historically Black Colleges and Universities (HBCU), a low number graduate (Tinto, 1993). It is, therefore, imperative that HBCUs implement strategies most likely to increase retention and persistence rates. When it comes to taking a closer look at pedagogy and practice in teaching, the COVID-19 Pandemic has created innovative environments for faculty to assess the students. The new perspective has many faculties utilizing evidence-based practices regarding performance-based assessment and other innovative techniques to assess students learning. Online teaching & learning and online assessment are likely to occupy a higher percentage of the future curriculum, which can be seen as a positive development for online learning. A correlation assumed that university faculty satisfaction and fair promotion could have a positive effect on student retention and engagement with a comprehensive analysis of these studies. It is paramount to consider that not only was fundamental student engagement found of tremendous relevance, but the literature is evident that student engagement during the entire higher education experience also leads to higher student retention rates and increased institutional commitment (Burke, 2019). This paper defines retention and persistence at HBCUs and presents the results of a systematic literature review that (a) identifies the challenges that impact student retention and persistence at HBCUs during the COVID-19 Pandemic and (b) delineates research-based practices/strategies recommended to address the academic, socio-emotional, and financial and health/wellness challenges of students attending HBCUs.
Reports on the topic "Qualitative research; systematic review; evidence-based practice"
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Mayanja, Maureen Nanziri, Rebecca Nalubega, John R. S. Tabuti, and Collins Grace Atuheire. Effectiveness of Ethnoveterinary Medicinal Plants of Eastern Africa in Control of Livestock Pests or Disease Pathogens: A Systematic Review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2022. http://dx.doi.org/10.37766/inplasy2022.9.0006.
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Review question / Objective: a) What is the current state and distribution of evidence on medicinal plants for ethnoveterinary practice in livestock keeping communities in Eastern Africa? b) What evidence exists about the pharmacological activities and effectiveness in control of livestock pests or disease pathogens, of ethnoveterinary medicinal plants accessible to the drylands of Eastern Africa? Information sources: This systematic review will consider both experimental and quasi-experimental evaluation studies that report positive outcomes; in-vivo and in-vitro assays and phytochemical composition assessment. Qualitative studies that focus on ethnoveterinary medicinal plant use including, but not limited to qualitative description and action research, will also be considered. In addition, systematic reviews that meet the inclusion criteria will be considered.
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Carney, Nancy, Tamara Cheney, Annette M. Totten, Rebecca Jungbauer, Matthew R. Neth, Chandler Weeks, Cynthia Davis-O'Reilly, et al. Prehospital Airway Management: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), June 2021. http://dx.doi.org/10.23970/ahrqepccer243.
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Objective. To assess the comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) by emergency medical services in the prehospital setting, and how the benefits and harms differ based on patient characteristics, techniques, and devices. Data sources. We searched electronic citation databases (Ovid® MEDLINE®, CINAHL®, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus®) from 1990 to September 2020 and reference lists, and posted a Federal Register notice request for data. Review methods. Review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center Program methods guidance. Using pre-established criteria, studies were selected and dual reviewed, data were abstracted, and studies were evaluated for risk of bias. Meta-analyses using profile-likelihood random effects models were conducted when data were available from studies reporting on similar outcomes, with analyses stratified by study design, emergency type, and age. We qualitatively synthesized results when meta-analysis was not indicated. Strength of evidence (SOE) was assessed for primary outcomes (survival, neurological function, return of spontaneous circulation [ROSC], and successful advanced airway insertion [for SGA and ETI only]). Results. We included 99 studies (22 randomized controlled trials and 77 observational studies) involving 630,397 patients. Overall, we found few differences in primary outcomes when airway management approaches were compared. • For survival, there was moderate SOE for findings of no difference for BVM versus ETI in adult and mixed-age cardiac arrest patients. There was low SOE for no difference in these patients for BVM versus SGA and SGA versus ETI. There was low SOE for all three comparisons in pediatric cardiac arrest patients, and low SOE in adult trauma patients when BVM was compared with ETI. • For neurological function, there was moderate SOE for no difference for BVM compared with ETI in adults with cardiac arrest. There was low SOE for no difference in pediatric cardiac arrest for BVM versus ETI and SGA versus ETI. In adults with cardiac arrest, neurological function was better for BVM and ETI compared with SGA (both low SOE). • ROSC was applicable only in cardiac arrest. For adults, there was low SOE that ROSC was more frequent with SGA compared with ETI, and no difference for BVM versus SGA or BVM versus ETI. In pediatric patients there was low SOE of no difference for BVM versus ETI and SGA versus ETI. • For successful advanced airway insertion, low SOE supported better first-pass success with SGA in adult and pediatric cardiac arrest patients and adult patients in studies that mixed emergency types. Low SOE also supported no difference for first-pass success in adult medical patients. For overall success, there was moderate SOE of no difference for adults with cardiac arrest, medical, and mixed emergency types. • While harms were not always measured or reported, moderate SOE supported all available findings. There were no differences in harms for BVM versus SGA or ETI. When SGA was compared with ETI, there were no differences for aspiration, oral/airway trauma, and regurgitation; SGA was better for multiple insertion attempts; and ETI was better for inadequate ventilation. Conclusions. The most common findings, across emergency types and age groups, were of no differences in primary outcomes when prehospital airway management approaches were compared. As most of the included studies were observational, these findings may reflect study design and methodological limitations. Due to the dynamic nature of the prehospital environment, the results are susceptible to indication and survival biases as well as confounding; however, the current evidence does not favor more invasive airway approaches. No conclusion was supported by high SOE for any comparison and patient group. This supports the need for high-quality randomized controlled trials designed to account for the variability and dynamic nature of prehospital airway management to advance and inform clinical practice as well as emergency medical services education and policy, and to improve patient-centered outcomes.
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Harris, Gregory, Brooke Hatchell, Davelin Woodard, and Dwayne Accardo. Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0010.
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Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.
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McDonagh, Marian S., Roger Chou, Jesse Wagner, Azrah Y. Ahmed, Benjamin J. Morasco, Suchitra Iyer, and Devan Kansagara. Living Systematic Reviews: Practical Considerations for the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. Agency for Healthcare Research and Quality (AHRQ), March 2022. http://dx.doi.org/10.23970/ahrqepcwhitepaperlsr.
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Living systematic reviews are a relatively new approach to keeping the evidence in systematic reviews current by frequent surveillance and updating. The Agency for Healthcare Research and Quality’s Evidence-based Practice Center Program recently commissioned a systematic review of plant-based treatments for chronic pain management. This white paper describes the team’s experience in implementing the protocol that was developed a priori, and reflects on the challenges faced and lessons learned in the process of developing and maintaining a living systematic review. Challenges related to scoping, conducting searches, selecting studies, abstracting data, assessing risk of bias, conducting meta-analysis, performing narrative synthesis, assessing strength of evidence, and generating conclusions are described, as well as potential approaches to addressing these challenges.
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Balk, Ethan M., Kristin J. Konnyu, Wangnan Cao, Monika Reddy Bhuma, Valery A. Danilack, Gaelen P. Adam, Kristen A. Matteson, and Alex Friedman Peahl. Schedule of Visits and Televisits for Routine Antenatal Care: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), June 2022. http://dx.doi.org/10.23970/ahrqepccer257.
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Background. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine plan a new evidence-based joint consensus statement to address the preferred visit schedule and the use of televisits for routine antenatal care. This systematic review will support the consensus statement. Methods. We searched PubMed®, Cochrane databases, Embase®, CINAHL®, ClinicalTrials.gov, PsycINFO®, and SocINDEX from inception through February 12, 2022. We included comparative studies from high-income countries that evaluated the frequency of scheduled routine antenatal visits or the inclusion of routine televisits, and qualitative studies addressing these two topics. We evaluated strength of evidence for 15 outcomes prioritized by stakeholders. Results. Ten studies evaluated scheduled number of routine visits and seven studies evaluated televisits. Nine qualitative studies also addressed these topics. Studies evaluated a wide range of reduced and traditional visit schedules and approaches to incorporating televisits. In comparisons of fewer to standard number of scheduled antenatal visits, moderate strength evidence did not find differences for gestational age at birth (4 studies), being small for gestational age (3 studies), Apgar score (5 studies), or neonatal intensive care unit (NICU) admissions (5 studies). Low strength evidence did not find differences in maternal anxiety (3 studies), preterm births (3 studies), and low birth weight (4 studies). Qualitative studies suggest that providers believe fewer routine visits may be more convenient for patients and may free up clinic time to provide additional care for patients with high-risk pregnancies, but both patients and providers had concerns about potential lesser care with fewer visits. In comparisons of hybrid (televisits and in-person) versus in-person only visits, low strength evidence did not find differences in preterm births (4 studies) or NICU admissions (3 studies), but did suggest greater satisfaction with hybrid visits (2 studies). Qualitative studies suggested patients and providers were open to reduced schedules and televisits for routine antenatal care, but importantly, patients and providers had concerns about quality of care, and providers and clinic leadership had suggestions on how to best implement practice changes. Conclusion. The evidence base is relatively sparse, with insufficient evidence for numerous prioritized outcomes. Studies were heterogeneous in the care models employed. Where there was sufficient evidence to make conclusions, studies did not find significant differences in harms to mother or baby between alternative models, but evidence suggested greater satisfaction with care with hybrid visits. Qualitative evidence suggests diverse barriers and facilitators to uptake of reduced visit schedules or televisits for routine antenatal care. Given the shortcomings of the evidence base, considerations other than proof of differences in outcomes may need to be considered regarding implications for clinical practice. New studies are needed to evaluate prioritized outcomes and potential differential effects among different populations or settings.
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Bahns, Carolin, Bettina Scheffler, and Christian Kopkow. Guideline adherence in physiotherapy – protocol for a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0081.
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Review question / Objective: The objective of this systematic review is to summarise different approaches reported in studies to evaluate guideline adherence in physiotherapy care. Further, we aim to identify clinical and methodological factors that may explain the assumed heterogeneity of guideline adherence among physiotherapists. Condition being studied: Clinical practice guidelines are systematically developed statements that summarise the current state of knowledge from research and practice. They are intended to support clinicians and patients to make decisions about appropriate health care for specific clinical circumstances (2). Various studies show that evidence-based physiotherapy care can lead to improved patient outcomes (e.g. pain, function, quality of life) and at the same time contribute to a lower utilisation of medical services and a reduction in health care costs. The degree of agreement between medical or therapeutic care and the recommendations made in guidelines is often described in studies with the term "guideline adherence". However, the heterogeneous use of the term guideline adherence and the lack of a standardised research methods or operationalisation lead to limited comparability of the study results.
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Nelson, Gena, Angela Crawford, and Jessica Hunt. A Systematic Review of Research Syntheses for Students with Mathematics Learning Disabilities and Difficulties. Boise State University, Albertsons Library, January 2022. http://dx.doi.org/10.18122/sped.143.boisestate.
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The purpose of this document is to provide readers with the coding protocol that authors used to code 36 research syntheses (including meta-analyses, evidence-based reviews, and quantitative systematic reviews) focused on mathematics interventions for students with learning disabilities (LD), mathematics learning disabilities (MLD), and mathematics difficulties (MD). The purpose of the systematic review of mathematics intervention syntheses was to identify patterns and gaps in content areas, instructional strategies, effect sizes, and definitions of LD, MLD, and MD. We searched the literature for research syntheses published between 2000 and 2020 and used rigorous inclusion criteria in our literature review process. We evaluated 36 syntheses that included 836 studies with 32,495 participants. We coded each synthesis for variables across seven categories including: publication codes (authors, year, journal), inclusion and exclusion criteria, content area focus, instructional strategy focus, sample size, methodological information, and results. The mean interrater reliability across all codes using this coding protocol was 90.3%. Although each synthesis stated a focus on LD, MLD, or MD, very few students with LD or MLD were included, and authors’ operational definitions of disability and risk varied. Syntheses predominantly focused on word problem solving, fractions, computer- assisted learning, and schema-based instruction. Syntheses reported wide variation in effectiveness, content areas, and instructional strategies. Finally, our results indicate the majority of syntheses report achievement outcomes, but very few syntheses report on other outcomes (e.g., social validity, strategy use). We discuss how the results of this comprehensive review can guide researchers in expanding the knowledge base on mathematics interventions. The systematic review that results from this coding process is accepted for publication and in press at Learning Disabilities Research and Practice.
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Dy, Sydney M., Julie M. Waldfogel, Danetta H. Sloan, Valerie Cotter, Susan Hannum, JaAlah-Ai Heughan, Linda Chyr, et al. Integrating Palliative Care in Ambulatory Care of Noncancer Serious Chronic Illness: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), February 2020. http://dx.doi.org/10.23970/ahrqepccer237.
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Objectives. To evaluate availability, effectiveness, and implementation of interventions for integrating palliative care into ambulatory care for U.S.-based adults with serious life-threatening chronic illness or conditions other than cancer and their caregivers We evaluated interventions addressing identification of patients, patient and caregiver education, shared decision-making tools, clinician education, and models of care. Data sources. We searched key U.S. national websites (March 2020) and PubMed®, CINAHL®, and the Cochrane Central Register of Controlled Trials (through May 2020). We also engaged Key Informants. Review methods. We completed a mixed-methods review; we sought, synthesized, and integrated Web resources; quantitative, qualitative and mixed-methods studies; and input from patient/caregiver and clinician/stakeholder Key Informants. Two reviewers screened websites and search results, abstracted data, assessed risk of bias or study quality, and graded strength of evidence (SOE) for key outcomes: health-related quality of life, patient overall symptom burden, patient depressive symptom scores, patient and caregiver satisfaction, and advance directive documentation. We performed meta-analyses when appropriate. Results. We included 46 Web resources, 20 quantitative effectiveness studies, and 16 qualitative implementation studies across primary care and specialty populations. Various prediction models, tools, and triggers to identify patients are available, but none were evaluated for effectiveness or implementation. Numerous patient and caregiver education tools are available, but none were evaluated for effectiveness or implementation. All of the shared decision-making tools addressed advance care planning; these tools may increase patient satisfaction and advance directive documentation compared with usual care (SOE: low). Patients and caregivers prefer advance care planning discussions grounded in patient and caregiver experiences with individualized timing. Although numerous education and training resources for nonpalliative care clinicians are available, we were unable to draw conclusions about implementation, and none have been evaluated for effectiveness. The models evaluated for integrating palliative care were not more effective than usual care for improving health-related quality of life or patient depressive symptom scores (SOE: moderate) and may have little to no effect on increasing patient satisfaction or decreasing overall symptom burden (SOE: low), but models for integrating palliative care were effective for increasing advance directive documentation (SOE: moderate). Multimodal interventions may have little to no effect on increasing advance directive documentation (SOE: low) and other graded outcomes were not assessed. For utilization, models for integrating palliative care were not found to be more effective than usual care for decreasing hospitalizations; we were unable to draw conclusions about most other aspects of utilization or cost and resource use. We were unable to draw conclusions about caregiver satisfaction or specific characteristics of models for integrating palliative care. Patient preferences for appropriate timing of palliative care varied; costs, additional visits, and travel were seen as barriers to implementation. Conclusions. For integrating palliative care into ambulatory care for serious illness and conditions other than cancer, advance care planning shared decision-making tools and palliative care models were the most widely evaluated interventions and may be effective for improving only a few outcomes. More research is needed, particularly on identification of patients for these interventions; education for patients, caregivers, and clinicians; shared decision-making tools beyond advance care planning and advance directive completion; and specific components, characteristics, and implementation factors in models for integrating palliative care into ambulatory care.
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Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.
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Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.